A woman has nonpruritic blisters and fragile skin on the dorsal surfaces of her hands. What is the cause of this blistering and how can it be treated?
Over a two-month period, a 52-year-old woman developed bilateral nonpruritic blisters and fragile skin, localised to the dorsal surfaces of her hands. The individual blisters healed with scars. Over the preceding six months, the patient had been taking naproxen for arthritis. She had a background of chronic solar damage. A skin biopsy revealed a subepidermal blister with scant dermal inflammation.